Provider Demographics
NPI:1073558557
Name:BIDDLE, PAUL THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:THOMAS
Last Name:BIDDLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:200 STERLING DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1577
Mailing Address - Country:US
Mailing Address - Phone:716-649-1613
Mailing Address - Fax:716-649-1506
Practice Address - Street 1:200 STERLING DR
Practice Address - Street 2:SUITE 202
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1577
Practice Address - Country:US
Practice Address - Phone:716-649-1613
Practice Address - Fax:716-649-1506
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227659-1208VP0014X, 208VP0000X
NY227659207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI25838Medicare UPIN